Data Conversion Specialist - Client Integration
Transamerica
in NY

Temporary Retirement Plan Operations Analyst
Milliman
in CA

Retirement Planning Specialist
Nationwide Financial
in CA

Director, Client Executive
Transamerica Retirement Solutions
in TX

Employee Benefits/ERISA Attorney
A full-service Upstate, NY firm
in NY

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401(k) Advanced Testing Techniques
January 28, 2015 WEBCAST
(ASPPA [American Society of Pension Professionals & Actuaries])

Guide to Target Date Fund Selection and Monitoring
February 25, 2015 WEBCAST
(Multnomah Group)

One Place 2015 Conference
March 9, 2015 in FL
(Benefitfocus)

Employee Ownership Conference 2015
April 21, 2015 in CO
(National Center for Employee Ownership)

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[Official Guidance]

Text of DOL, HHS and IRS Proposed Regs: Amendments to Excepted Benefits
"After consideration of comments on the 2013 proposed regulations, the Departments are publishing these proposed regulations to address limited wraparound coverage and solicit comment before promulgation of final regulations on limited wraparound benefits.... These proposed regulations seek comment on two options for limited wraparound coverage to be considered an excepted benefit. The Departments intend that, after notice and comment, one or both options could be finalized. (That is, they are not necessarily alternatives and, therefore, could be implemented side by side). The regulations include a sunset date and, therefore, would operate as a pilot program. While some elements of this proposal are the same as those in the previous proposal, this new proposal contains changes in response to suggestions and adds new elements for reporting and data collection to gather information to inform future rulemaking.... These proposed regulations set forth five requirements under which limited benefits provided through a group health plan that wrap around either eligible individual insurance or coverage under a Multi-State Plan (limited wrap around coverage) constitute excepted benefit ... [1] Covers additional benefits ... [2] Limited in amount ... [3] Nondiscrimination ... [4] Plan eligibility requirement ... [5] Reporting." (Employee Benefits Security Administration [EBSA], U.S. Department of Labor; Internal Revenue Service [IRS]; and U.S. Department of Health and Human Services [HHS])  

[Advert.]

24th Annual National Health Benefits Conference & Expo (HBCE)

Plan now to attend the National Health Benefits Conference & Expo, January 27-28 in Clearwater Beach, Florida. The conference provides cutting-edge case studies and advanced cost control strategies presented by national thought leaders. Register Now!

[Official Guidance]

Text of CMS Draft 2016 Letter to Issuers in the Federally-facilitated Marketplaces and SHOPs (PDF)
59 pages. "This Letter provides issuers seeking to offer qualified health plans (QHPs), including stand-alone dental plans (SADPs), in the Federally-facilitated Marketplaces (FFMs) or the Federally-facilitated Small Business Health Options Programs (FF-SHOPs) with operational and technical guidance to help them success fully participate in those Marketplaces in 2016. Unless otherwise specified, references to the FFMs include the FF-SHOPs. Throughout this Letter, CMS identifies the areas in which states performing plan management functions in the FFMs have flexibility to follow an approach different from that articulated in this guidance. CMS notes that the policies articulated in this Letter apply to the certification process for plan years beginning in 2016." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Official Guidance]

Text of 2014 Instructions for IRS Form 8965: Health Coverage Exemptions (and Instructions for Figuring Your Shared Responsibility Payment) (PDF)
"Beginning in 2014, individuals must have health care coverage, have a health coverage exemption, or make a shared responsibility payment with their tax return. Use Form 8965 to report a coverage exemption granted by the Marketplace (also called the Exchange) or to claim a coverage exemption on your tax return. In addition, if for any month you or another member of your tax household had neither health care coverage nor a coverage exemption, these instructions provide the information you will need to calculate your shared responsibility payment." (Internal Revenue Service [IRS])  

[Guidance Overview]

What Will 2015 Hold for the ACA and Employers?
"Despite the detailed discussion of the lookback measurement and method in the final rule, a number of questions and ambiguities remain.... Although the use of the lookback approach is complicated and administratively burdensome, it does afford more flexibility and certainty than a strict monthly calculation. Looking ahead to 2015, the questions and challenges regarding determination of full-time employee status are likely to grow. Although additional guidance from the IRS may be forthcoming, employers will enter the new year with compliance challenges ahead." (Littler)  

FMLA Leave for Headache Effectively Converts Full-Time Position into Part-Time Position; Employers' Shrieks Heard Across the Country
"The court also addressed a larger issue that it acknowledged was a novel question: Could Sam use his annual FMLA allotment to effectively convert his full-time position into one that no longer required overtime? Or taken further, could an employee use FMLA leave also to convert a full-time position into a part-time version of the same? In short, the court said 'Yes,' and reminded us that the FMLA does what the ADA cannot. Specifically, the ADA does not require an employer to eliminate an essential function (such as overtime) or provide an accommodation that would cause an undue hardship. However, the same is not true for the FMLA." [Santiago v. Dep't of Transp., No. 3:12cv132 (D. Conn. Sept. 25, 2014)] (FMLA Insights)  

[Advert.]

ACA play-or-pay rules are complex

Mercer Select can help. With a user-friendly website and daily emails, Mercer Select members stay informed about the ACA and other key benefit, comp and HR issues. Sign up for a free demo or guest membership.

Tax Implications for Employer-Paid Life Insurance Coverage (PDF)
"[This article] explains the impact of Section 79 on employer-sponsored group term life plans, voluntary life plans, discriminatory life plans and the potential tax consequences for your employees... Each section details potential tax consequences for each situation ... [and explains] how to calculate tax liability." (McGraw Wentworth)  

How Responsive Are Millennial Employees to Your Wellness Efforts?
"Millennials are the least likely to participate in activities focused on prevention and maintaining or improving physical health compared to other generations. About half (54 percent) have had a physical in the last 12 months, compared to 60 percent of Generation X and 73 percent of Baby Boomers.... More than half (52 percent) say 'living or working in a healthy environment' is influential to their personal health, compared to 42 percent of Generation X and 35 percent of Baby Boomers. Millennials also are more open to having their direct manager play an active role in encouraging them to get and stay healthy (53 percent), compared to 47 percent of Generation X and 41 percent of Baby Boomers[.]" (Wolters Kluwer Law & Business)  

The Year in Exchanges: Where Private Exchanges Go from Here
"[T]he majority of employers are still waiting to see evidence of what value private exchanges provide, but more importantly, are waiting for someone else in their market to make the jump first, says Jean Moore, managing director of Towers Watson Active Exchange. According to Moore, 34% of employers are waiting for someone else to switch. Once that happens, she expects others will follow right away -- even before data about the move comes in." (Employee Benefit Adviser)  

Active and Retired Public Employees' Health Insurance: Potential Data Sources
"Employer-provided health insurance for public sector workers is a significant public policy issue. Underfunding and the growing costs of benefits may hinder the fiscal solvency of state and local governments. Findings from the private sector may not be applicable because many public sector workers are covered by union contracts or salary schedules and often benefit modifications require changes in legislation. Research has been limited by the difficulty in obtaining sufficiently large and representative data on public sector employees. This article highlights data sources researchers might utilize to investigate topics concerning health insurance for active and retired public sector employees." (Journal of Health Economics; purchase required)  

HMOs Offer Lower Price Increases in Health Care Marketplaces
"Plans featuring health maintenance organizations or restricted networks of providers typically had the lowest year-over-year premium increases, according to McKinsey, which sifted through information on the 223,000 plans offered in the marketplaces at the county level over the last two years. Plans featuring an H.M.O. had a median increase of only 2 percent. The more widely known P.P.O., or preferred provider organization, plans, which typically allow people to go outside their plan's network if they are willing to pay a greater share of the cost, had a median increase of 9 percent." (The New York Times; subscription may be required)  

Regence BlueShield Bets on 'Accountable Health' Group Plans
"One Blue insurer will find out just how much employer appetite there is for health plans with limited but transparent networks branded as both accountable and affordable. Washington State's Regence BlueShield, one of the four Blues insurers in the Cambia Health Solutions family, is introducing ActiveCare, a new group health plan offering built on accountable care partnership with four providers that form network choices.... Members enrolled in the ActiveCare plans choose a primary care physician from the affiliated provider system, and those primary care doctors then are tasked with coordinating healthcare needs and overseeing referrals within the parent organization." (Healthcare Payer News)  

How the High Cost of Medical Care Is Affecting Americans
"Nearly half of respondents described the affordability of basic medical care as a hardship for them and their family, up 10 points from a year ago. While the [ACA] has expanded insurance to millions of Americans, including those with existing conditions, it does not directly address cost. And cost is becoming increasingly problematic." (The New York Times; subscription may be required)  

Vermont Abandons Single Payer, for Now
"Three years after Vermont's legislature passed Act 48 creating a roadmap for a state-financed single payer system called Green Mountain Care, Governor Peter Shumlin has abandoned the idea ... A team within the Shumlin Administration had drafted a financing proposal to fund Green Mountain Care, a public healthcare plan envisioned to cover 94 percent of healthcare costs for all Vermonters except those enrolled in Medicaid or Tricare. The proposal called for an 11.5 percent payroll tax on all businesses, as well as a 9.5 percent assessment on individuals earning over 400 percent of the poverty level, with a lower, sliding scale tax for those earning under 400 percent FPL." (Healthcare Payer News)  

Aetna Rate Hike Excessive, California Insurance Commissioner Says
"[California Insurance] Commissioner Dave Jones lashed out ... at the third-largest U.S. health insurer for raising premiums as much as 20% on some small businesses starting Jan. 1. The average increase of 10.7% will cost small employers and their workers $23.5 million in excessive premiums, according to the state. But Jones has no power to stop it. California voters last month soundly rejected Proposition 45, which would have enabled him to block rate hikes that his department deemed unreasonable." (Los Angeles Times)  

257,000 Doctors Will Get Medicare Pay Cut for Using Paper Records
"[CMS] is telling about 257,000 eligible medical care providers who are largely physicians that they will be paid 1 percent less in reimbursement next year from both the Medicare health insurance program for the elderly and the Medicaid insurance program for the poor because they failed to comply with so-called 'Meaningful Use' of electronic health records standards in 2013." (Forbes)  

Medicaid Rolls Surge Under ACA
"Even though state policy wasn't changing everywhere, all the talk about new health insurance options and the resources devoted to helping people sign up led to a surge among people who had always been eligible for the program. Altogether, enrollment in the nonexpansion group of states has increased by 6.8 percent, or about 1.5 million people. Of course, the increases in states that have expanded Medicaid are more extreme. In Kentucky, the state with the biggest increase, the Medicaid rolls have grown by 71 percent." (The New York Times; subscription may be required)  

[Guidance Overview]

2015 Reporting and Disclosure Calendar for Single-Employer Benefit Plans (PDF)
27 pages. Detailed list of compliance requirements and dates; covers DOL, HHS and IRS requirements for welfare plans as well as retirement plans. Interactive version is also available. (Sibson Consulting)  

[Guidance Overview]

2015 Reporting & Disclosure Calendar for Multiemployer Benefit Plans (PDF)
27 pages. Detailed list of compliance requirements and dates; covers DOL, HHS and IRS requirements for welfare plans as well as retirement plans. Interactive version is also available. (Segal Consulting)  

Baby Boomer Workers Revolutionize Retirement, But Are They and Their Employers Ready? (PDF)
"Sixty-five percent of Baby Boomer workers plan to work past age 65 or do not plan to retire. More than half (52 percent) plan to continue working after they retire.... 62 percent of the Baby Boomer workers who plan to work in retirement and/or past age 65 indicate that their main reason is income or health benefits.... [The] majority of employers share positive perceptions of their older workers with 87 percent saying that they are 'a valuable resource for training and mentoring' and 86 percent identifying them as 'an important source of institutional knowledge.' Many employers do feel they have higher healthcare costs (57 percent), but only 28 percent cite higher disability costs." (Transamerica Center for Retirement Studies)  

PSA Bolsters Retirement Practice With Staff Additions
PSA Insurance & Financial Services, Inc. [PSA]

Benefitfocus Expands Its Ecosystem To Offer Employers the Health E(fx) ACA Platform
Benefitfocus

Benefitfocus Expands Its Ecosystem of Enterprise-level Third Party System Integrators
Benefitfocus

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